scholarly journals Attitudes and Recommendations of Physicians towards Alcohol Consumption and Cardiovascular Health: A Perspective from Argentina

2018 ◽  
Author(s):  
Ricardo Lopez Santi ◽  
Sohaib Haseeb ◽  
Bryce Alexander ◽  
Adrian D’Ovidio ◽  
Sergio Gimenez ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Intake ◽  
Cardiovascular Health ◽  
Physician Attitudes ◽  
Standard Drink ◽  
Sources Of Knowledge ◽  
Safe Limits ◽  
To Come ◽  
Moderate Alcohol Intake ◽  
Study Participants

Despite epidemiological findings of improvements in cardiovascular risk factors with a light-to-moderate intake of alcohol, many misconceptions remain regarding alcohol intake and the risks and benefits of consumption. We sought to examine physician attitudes and recommendations regarding alcohol intake in a cohort of Argentine physicians and to establish their sources of knowledge. An online national survey was distributed through the Argentine Federation of Cardiology (FAC) to cardiologists, internal medicine specialists, general and other subspecialty physicians in Argentina. The survey was completed by 745 physicians, of whom 671 (90%) were cardiologists. In total, 35% of physicians viewed moderate alcohol intake to be beneficial for cardiovascular health, 36% believed only wine offered such benefits, 24% viewed any intake to be harmful, and 5% had other opinions. More than half (57%) self-reported their knowledge to come from academic sources. Regarding knowledge of drinking guidelines, only 41% of physicians were aware of the concept of ‘standard drink’. Physicians were generally not comfortable converting ‘standard drinks’ into other metric units, however men tended to be more comfortable than women (p=0.052). Physicians were not satisfied with their knowledge of drinking guidelines (3.01 ± 2.73, on a 0-10 scale). Physicians were generally comfortable in counselling patients regarding safe-limits of consumption (6.22 ± 3.20, on a 0-10 scale). Argentine physicians were not satisfied with their knowledge of alcohol consumption guidelines or their understanding of the reported metrics. Only one-third of study participants viewed moderate alcohol intake as beneficial for cardiovascular health. This study shows the necessity to optimize the sources of knowledge.

Abstract P420: Alcohol Consumption and Longitudinal Changes in Magnetic Resonance Imaging-defined Brain Abnormalities: The Cardiovascular Health Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Simona Costanzo ◽  
Traci M Bartz ◽  
Giovanni de Gaetano ◽  
Augusto F Di Castelnuovo ◽  
Licia Iacoviello ◽  
...  
Keyword(s):  
White Matter ◽  
Alcohol Consumption ◽  
Brain Atrophy ◽  
Alcohol Intake ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Brain Volumes ◽  
Total Brain

Introduction: Alcohol intake has been related with a complex group of associations with brain structure in cross-sectional analyses, but to our knowledge, its prospective relationship with structural brain abnormalities detected by MRI has never been reported. Hypothesis: We hypothesized that consumers of 1-<7 drinks/week would have slower progression of leukoaraiosis (white matter abnormalities) but more rapid progression of brain atrophy than longer-term abstainers. Methods: As part of the Cardiovascular Health Study, 1 996 adults aged ≥65 years underwent MRI scanning in 1991-94 and again in 1997-99, having excluded 120 participants with a history of cerebrovascular disease before the initial scan. Alcohol consumption was assessed at each annual visit by self-reported intake of wine, beer and liquor. A 10-point white matter grade (WMG) and ventricular grade (VG) were assessed in a standardized and blinded manner in both scans; hippocampal and total brain volumes were also quantified on the second scan. We estimated the associations of alcohol intake in categories (as reported closest to the date of initial scan), with MRI findings at follow-up with multinomial ordered logistic regression (WMG ≤ 3 ref and ≥ 4; VG ≤ 3 ref , =4 and ≥5) using inverse probability weighting to account for attrition. Results: We observed a U-shaped association with WMG, with significantly lower risk among participants consuming 1-<7 drinks/week (OR 0.38; 95% CI 0.17-0.82, table) than long-term abstainers (P quadtrend = 0.01). For VG, the association was inverse (P trend = 0.06), with significantly less progression among drinkers of 1-<7 drinks/week than long-term abstainers (OR 0.62; 95% CI 0.40-0.97). We identified no significant associations of alcohol intake with quantitative mean hippocampal or total brain volumes at the second scan. Conclusions: Compared with long-term abstention, consumption of 1-<7 drinks/week of alcohol was generally associated with less progression of leukoaraiosis and some measures of brain atrophy in older adults.

scholarly journals Impact of evening alcohol consumption on nocturnal autonomic and cardiovascular function in adult men and women: a dose–response laboratory investigation

SLEEP ◽  
2020 ◽  
Author(s):  
Massimiliano de Zambotti ◽  
Mohamad Forouzanfar ◽  
Harold Javitz ◽  
Aimee Goldstone ◽  
Stephanie Claudatos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Alcohol Consumption ◽  
Blood Pressure Monitoring ◽  
Alcohol Ingestion ◽  
High Dose ◽  
Standard Drink ◽  
Men And Women ◽  
Adult Men ◽  
Alcohol Dose ◽  
Moderate Alcohol Intake

Abstract Study Objectives To investigate the dose-dependent impact of moderate alcohol intake on sleep-related cardiovascular (CV) function, in adult men and women. Methods A total of 26 healthy adults (30–60 years; 11 women) underwent 3 nights of laboratory polysomnographic (PSG) recordings in which different doses of alcohol (low: 1 standard drink for women and 2 drinks for men; high: 3 standard drinks for women and 4 drinks for men; placebo: no alcohol) were administered in counterbalanced order before bedtime. These led to bedtime average breath alcohol levels of up to 0.02% for the low doses and around 0.05% for the high doses. Autonomic and CV function were evaluated using electrocardiography, impedance cardiography, and beat-to-beat blood pressure monitoring. Results Presleep alcohol ingestion resulted in an overall increase in nocturnal heart rate (HR), suppressed total and high-frequency (vagal) HR variability, reduced baroreflex sensitivity, and increased sympathetic activity, with effects pronounced after high-dose alcohol ingestion (p’s &lt; 0.05); these changes followed different dose- and measure-dependent nocturnal patterns in men and women. Systolic blood pressure showed greater increases during the morning hours of the high-alcohol dose night compared to the low-alcohol dose night and placebo, in women only (p’s &lt; 0.05). Conclusions Acute evening alcohol consumption, even at moderate doses, has marked dose- and time-dependent effects on sleep CV regulation in adult men and women. Further studies are needed to evaluate the potential CV risk of repeated alcohol-related alterations in nighttime CV restoration in healthy individuals and in those at high risk for CV diseases, considering sex and alcohol dose and time effects.

scholarly journals Alcohol consumption in later life and reaching longevity: the Netherlands Cohort Study

2020 ◽  
Vol 49 (3) ◽  
pp. 395-402 ◽  
Author(s):  
Piet A van den Brandt ◽  
Lloyd Brandts
Keyword(s):  
Cohort Study ◽  
The Netherlands ◽  
Binge Drinking ◽  
Alcohol Intake ◽  
Cox Regression ◽  
Later Life ◽  
History Of ◽  
Using Data ◽  
Moderate Alcohol Intake ◽  
Study Participants

Abstract Background whether light-to-moderate alcohol intake is related to reduced mortality remains a subject of intense research and controversy. There are very few studies available on alcohol and reaching longevity. Methods we investigated the relationship of alcohol drinking characteristics with the probability to reach 90 years of age. Analyses were conducted using data from the Netherlands Cohort Study. Participants born in 1916–1917 (n = 7,807) completed a questionnaire in 1986 (age 68–70 years) and were followed up for vital status until the age of 90 years (2006–07). Multivariable Cox regression analyses with fixed follow-up time were based on 5,479 participants with complete data to calculate risk ratios (RRs) of reaching longevity (age 90 years). Results we found statistically significant positive associations between baseline alcohol intake and the probability of reaching 90 years in both men and women. Overall, the highest probability of reaching 90 was found in those consuming 5– &lt; 15 g/d alcohol, with RR = 1.36 (95% CI, 1.20–1.55) when compared with abstainers. The exposure-response relationship was significantly non-linear in women, but not in men. Wine intake was positively associated with longevity (notably in women), whereas liquor was positively associated with longevity in men and inversely in women. Binge drinking pointed towards an inverse relationship with longevity. Alcohol intake was associated with longevity in those without and with a history of selected diseases. Conclusions the highest probability of reaching 90 years was found for those drinking 5– &lt; 15 g alcohol/day. Although not significant, the risk estimates also indicate to avoid binge drinking.

Alcohol use among older adults

2010 ◽  
Vol 20 (1) ◽  
pp. 56-68 ◽  
Author(s):  
Philip D St John ◽  
Wanda M Snow ◽  
Suzanne L Tyas
Keyword(s):  
Older Adults ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Intake ◽  
Alcohol Misuse ◽  
Heavy Episodic Drinking ◽  
Policy Makers ◽  
Alcohol Interventions ◽  
Screening Questionnaires ◽  
Moderate Alcohol Intake

SummaryAlcohol use is common in older adults and is associated with numerous health and social problems. Recent evidence suggests that in addition to level of alcohol consumption, drinking pattern may also be important. Moderate alcohol intake may confer some cardiac benefits, while heavy episodic drinking seems particularly problematic. Detecting alcohol misuse in older adults is difficult since clinical acumen is often poor, screening questionnaires have serious limitations and laboratory tests are not diagnostic. Brief alcohol interventions to reduce alcohol consumption appear useful in younger populations, but are less studied in older adults. While there is increasing research into the issue of alcohol use among older adults, clinicians and policy-makers must rely on limited evidence when making clinical decisions.

Abstract P236: Association Between Alcohol and Ideal Cardiovascular Health: The Multi-Ethnic Study of Atherosclerosis

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Oluseye Ogunmoroti ◽  
Olatokunbo Osibogun ◽  
Robyn L McClelland ◽  
Erin D Michos ◽  
Gregory L Burke ◽  
...  
Keyword(s):  
Alcohol Intake ◽  
Cardiovascular Health ◽  
Multinomial Logistic Regression ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Ideal Cardiovascular Health ◽  
Logistic Regression Models ◽  
Race Ethnicity ◽  
Moderate Alcohol Intake ◽  
Heavy Alcohol Intake

Introduction: Alcohol intake is associated with cardiovascular disease (CVD), with moderate drinkers having a decreased CVD risk compared to non- and heavy drinkers. However, this association is yet to be examined using the AHA Life’s Simple 7 (LS7) metrics as a proxy for cardiovascular health (CVH). We explored associations between alcohol intake and CVH in a multi-ethnic population. Methods: Our cross-sectional analyses included 6,506 MESA participants, free of CVD, aged 45 to 84 years. The LS7 metrics (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose) were each scored 0-2, with 2 indicating “ideal”, 1 “intermediate” and 0 “poor”. Total LS7 score ranged from 0-14. Alcohol data was obtained from personal history and food frequency questionnaires. Participants were classified as never, former or current drinkers. Current drinkers were categorized as <1 (light), 1-2 (moderate) and >2 (heavy) drinks/day. Multinomial logistic regression models assessed associations between alcohol intake and CVH, adjusted for age, sex, race/ethnicity, education, income and health insurance. Results: Mean (SD) age was 62 (10) years, 53% were women; 20% were never, 24% former and 56% current drinkers. Among current drinkers, 44% had <1, 9% 1-2 and 3% >2 drinks/day. Additionally, 47% had inadequate LS7 scores, 33% average and 20% optimal. Compared to never drinkers, those who drank <1 drink/day were more likely to have average and optimal scores, although most of the associations were not significant. Women with 1-2 drinks/day were more likely than men to have optimal scores. Overall and in men, those who drank >2 drinks/day were less likely to have average or optimal scores. Whites and Hispanics with >2 drinks/day were less likely to have optimal and average scores, respectively (Table). Conclusion: Light alcohol intake tended to show favorable CVH, whereas heavy alcohol intake was unfavorable. For moderate alcohol intake, the associations with CVH varied by sex and race/ethnicity.

Benefits and hazards of alcohol-the J-shaped curve and public health

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Erik Skovenborg ◽  
Morten Grønbæk ◽  
R. Curtis Ellison
Keyword(s):  
Public Health ◽  
Alcohol Consumption ◽  
Alcohol Intake ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Epidemiological Studies ◽  
Protective Effects ◽  
Content Type ◽  
All Cause Mortality ◽  
Moderate Alcohol Intake

Purpose The purpose of this paper is a review of updated evidence of a J-shaped association between alcohol consumption and the risk of coronary heart disease (CHD) and all-cause mortality in relation to public health issues to create a basis for sensible individual health deliberations. Design/methodology/approach A review of the evidence from the first observation of a J-shaped association between a moderate alcohol intake and CHD in 1926 to recent studies of the effect of healthy lifestyles (including moderate alcohol intake) on life expectancy free of cardiovascular disease (CVD), cancer and Type 2 diabetes. An update on the biological plausibility of the J-shaped association with focus on recent findings of the association of alcohol intake and blood lipid levels. Findings Plausible J-shaped relations between light to moderate alcohol consumption and the risk of CHD, CVD mortality and all-cause mortality have been found in a large number of robust epidemiological studies. Among the potential mechanisms underlying the proposed protective effects are higher levels of high-density lipoprotein lacking apolipoprotein C3, reduced platelet aggregability, increased level of endothelial cell fibrinolysis, increased insulin sensitivity and decreased inflammation. Originality/value The existence of a J-shaped association between alcohol consumption and the risk of CHD and all-cause mortality is based on observational evidence and accordingly challenged by a degree of uncertainty leading some public health circles to state: “there is no safe level of alcohol consumption.” The authors propose that communication on the pros and cons of alcohol intake should emphasize the nadir of a J-shaped curve as a healthy range for the general population while advice regarding the consumption of alcohol should be adjusted to factor in the risks and potential benefits for each individual patient considering age, sex, family history, personal drinking history and specific medical history.

scholarly journals Deterioration of binocular vision after alcohol intake influences driving performance

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Francesco Martino ◽  
José Juan Castro-Torres ◽  
Miriam Casares-López ◽  
Sonia Ortiz-Peregrina ◽  
Carolina Ortiz ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Binocular Vision ◽  
Visual Function ◽  
Alcohol Intake ◽  
Driving Simulator ◽  
Driving Performance ◽  
Significant Deterioration ◽  
Simulated Driving ◽  
Visual Deterioration ◽  
Moderate Alcohol Intake

AbstractIn this study, we assessed the influence of moderate alcohol intake on binocular vision, vergence system and simulated driving performance by analyzing the interactions between visual deterioration and driving variables. Thirty young healthy subjects were recruited. For the analysis, we measured: visual function (visual acuity and stereoacuity), phorias and fusional reserves. Also, we checked Sheard’s and Percival’s criteria at near and far. The accommodative convergence/accommodation (AC/A) ratio was calculated and vergence facility was also obtained at near. A driving simulator was used to assess driving performance under natural conditions and after alcohol consumption with a breath alcohol content of 0.40 mg/l. Alcohol intake significantly reduced binocular visual performance and vergence function, except for vertical phorias, horizontal phoria at near and Sheard’s and Percival’s criteria at near. Driving performance parameters also presented a statistically significant deterioration after alcohol consumption. A statistically significant correlation was found between the deterioration in overall visual function and overall driving performance, highlighting the influence of the visual deterioration on the driving performance. Moderate alcohol consumption impairs binocular visual and simulated driving performances, implying a greater safety hazard. In addition, deteriorations in binocular visual function and vergence correlated with simulated driving impairment, which indicates that the deterioration of binocular vision due to alcohol consumption affects driving, thus reducing road safety.

scholarly journals Alcohol Consumption And Cardiovascular Mortality In Hypertensive Patients

Circulation ◽  
2001 ◽  
Vol 103 (suppl_1) ◽  
pp. 1367-1367
Author(s):  
Maciej K. Malinski ◽  
Howard D. Sesso ◽  
Francisco Lopez-Jimenez ◽  
Julie E. Buring ◽  
J. Michael Gaziano
Keyword(s):  
Alcohol Consumption ◽  
Cardiovascular Mortality ◽  
Alcohol Intake ◽  
Linear Trend ◽  
Health Study ◽  
Moderate Alcohol Consumption ◽  
Hypertensive Patients ◽  
All Cause Mortality ◽  
History Of ◽  
Moderate Alcohol Intake

P83 Background: Alcohol drinking is associated with a dose-dependent increase in blood pressure, and JNC VI advises limiting alcohol consumption in patients with hypertension. Data are sparse on relationship between alcohol consumption and mortality in hypertensive patients. We therefore assessed whether alcohol consumption is associated with decrease in total, and cardiovascular mortality among subjects with hypertension. Methods: From the enrollment cohort of 89,251 men from the Physicians’ Health Study who provided self-reported information on alcohol intake and were free of myocardial infarction, stroke, cancer or liver disease at baseline, we identified a group of 14,125 persons with a history of current or past treatment for hypertension. Results: During 75,710 person-years of follow up, there were 1,018 deaths including 579 from cardiovascular disease and 224 from cancer. In multivariate analyses that controlled for several potential confounders, moderate alcohol intake was associated with significant decrease in cardiovascular mortality (P<0.001 for linear trend). Compared with non-drinking men, those who drank 1 to 3 drinks per month had a RR for cardiovascular mortality of 0.86 (CI 0.63-1.18, P=0.35); for 1 to 6 drinks per week, the RR was 0.64 (CI 0.51-0.81, P<0.001); for >= 1 drink per day the RR was 0.57 (CI 0.44-0.72, P<0.001). RR values for all-cause mortality in the same groups were respectively 0.89 (CI 0.70-1.15, P=0.38); 0.73 (CI 0.60-0.88, P=0.001); and 0.73 (CI 0.61-0.89, P=0.0014)(P=0.0025 for linear trend). On the other hand, we found no significant association between moderate alcohol consumption and cancer mortality (P=0.68 for linear trend). Conclusion: These results suggest that light to moderate alcohol consumption is associated with a significant reduction in cardiovascular and all-cause mortality in patients with hypertension.

Meta-analysis of alcohol consumption and venous thromboembolism

2021 ◽  
Author(s):  
Xingxia Zhang ◽  
Xinrong Chen ◽  
Jie Yang ◽  
Liang Du ◽  
Yong Zhou ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Alcohol Consumption ◽  
Alcohol Intake ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Reference List ◽  
Case Control Studies ◽  
The Difference ◽  
Moderate Alcohol Intake ◽  
The Cochrane Library

Abstract Background The associations of alcohol consumption and venous thromboembolism (VTE) have been investigated widely, but the conclusions were inconsistent. Objective To summarize the relationship of alcohol consumption and VTE. Methods This study has been registered in PROSPERO (ID: CRD42020164567). We searched the PubMed, Embase, Web of Science and the Cochrane Library databases from inception to September 2019 and reviewed the reference list of relevant articles to identify studies assessing the association between alcohol consumption and risk of VTE. Results Fourteen cohorts and four case-control studies were included in the meta-analysis. Compared with non-drinkers, the risk of VTE was decreased (RR: 0.93; 95% confidence interval [CI] 0.88–0.99) for alcohol drinkers. The pooled RRs of VTE were 0.91 (95% CI 0.84–0.99) for low to moderate alcohol intake (0.1–14.0 drinks/week) and 0.91 (95% CI 0.78–1.06) for high alcohol intake (&gt;14.0 drinks/week) compared with non-drinker. Subgroup analysis showed liquor intake might slightly increase the risk of VTE (1.01; 95% CI 0.85–1.21) although the difference was not significant. Conclusions Alcohol consumption in low to moderate was associated with a lower risk of VTE. However, precautions are needed when providing personal drinking advice considering the potential harm of alcohol. Further studies are warranted to determine whether moderate alcohol consumption has a causal role in VTE.

Abstract 056: Alcohol Increases Risk Of Cardiovascular Disease At All Levels Of Intake

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Kiran J Biddinger ◽  
Connor Emdin ◽  
Mary E Haas ◽  
Minxian Wang ◽  
George Hindy ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Alcohol Consumption ◽  
Alcohol Intake ◽  
Mendelian Randomization ◽  
Lifestyle Factors ◽  
Non Linear ◽  
Increase Risk ◽  
The Uk ◽  
Study Participants

Genetic analyses have suggested a causal association between alcohol intake and cardiovascular diseases, questioning the purported cardioprotective effects of modest intake. Though traditional approaches to genetic epidemiology are limited in ability to assess association shapes, we hypothesized that any alcohol may increase risk of cardiovascular disease. In 371,463 participants from the UK Biobank, we first examined for confounding in epidemiological associations between alcohol intake and cardiovascular diseases. Next, using traditional and non-linear genetic approaches (Mendelian randomization), we assessed for causal links of alcohol consumption with several cardiovascular diseases and evaluated the shapes of all causal associations identified. Study participants consumed 9.2 (SD, 10.6) standard drinks per week on average; 121,708 (32.8%) and 27,667 (7.5%) subjects had hypertension and CAD, respectively. Modest consumers of alcohol demonstrated healthier lifestyles - such as lower BMI and greater physical activity - than abstainers, and adjustment for lifestyle factors attenuated the observed benefits of light alcohol intake. Traditional and non-linear Mendelian randomization demonstrated consistently risk-increasing and quadratic associations between alcohol consumption and both clinical and subclinical cardiovascular disease, with exponential increases in risk across levels of drinking; relative to abstainers, consumption of 7, 14, 21, and 28 drinks per week conferred 1.2, 1.7, 3.4, and 8.9-fold odds of hypertension and 1.2, 2.3, 6.2, and 25.9-fold odds of CAD, respectively (both models p<0.001). In conclusion, coincident, favorable lifestyle factors may mediate the observational benefits of modest alcohol intake. All amounts of alcohol intake increase cardiovascular risk, but marked absolute and relative risk differences exist across levels of intake, which should inform public health recommendations around habitual alcohol consumption.

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